BACKGROUND AND PURPOSE:

• Wilson et al. (AJOG, 2018) sought to determine whether receiving a hysterectomy, with or without oophorectomy, before the age of 50 had a higher all-cause mortality

METHODS:

• Study sample derived from a prospective cohort study
  • Designed to assess physical and mental health
• Women reported either
  • Hysterectomy with bilateral oophorectomy
  • A hysterectomy without bilateral oophorectomy (retained one or both ovaries)
  • No hysterectomy
• Exposure groups were stratified by menopausal hormone therapy use
• Covariates also analyzed included
  • Demographics/income | Health behaviors such as smoking and alcohol consumption | Medical history such as diabetes and/or obesity

RESULTS:

• 13,541 women were included in the study
  • Median follow-up of 21.5 years
• Overall, there was no difference in all-cause mortality compared to women with no hysterectomy
  • Women who reported a hysterectomy and bilateral oophorectomy
    • Hazard ratio (HR) 1.02 (95% confidence interval, 0.78–1.34)
  • Women who reported a hysterectomy with ovarian conservation
    • HR 0.86 (95% confidence interval, 0.72–1.02)
  • When stratified by hormone therapy
    • Hysterectomy and ovarian conservation <50 years were not at higher risk of all-cause mortality compared to no hysterectomy, regardless of hormone therapy
    • In nonusers of hormone therapy, hysterectomy-with bilateral oophorectomy <50 years was associated with increased mortality vs no hysterectomy
      • HR 1.81 (95% confidence interval, 1.01–3.25)

CONCLUSION:

• Hysterectomy and ovarian conservation <50 did not increase risk of all-cause mortality
• Hysterectomy without ovarian conservation and no hormone therapy did increase risk of all-cause mortality

Learn More – Primary Sources:

Hysterectomy status and all-cause mortality in a 21-year Australian population-based cohort study

Related ObG Topics:

‘Opportunistic’ Salpingectomy at the Time of Hysterectomy: Risks vs Benefits

The WHI Randomized Trials: Is Menopausal Hormone Therapy Associated with Long-Term Mortality?

Does Hormone Therapy in Menopause Impact Mortality?